ADHD and sleep solutions?

My son is 8 and has been taking Adderall for about 1.5 years. The medication is SO helpful with his focus, but he already had some difficulty sleeping, and the medication just makes it even harder (super common side effect, I know). Recently we increased his dosage--supervising distance learning showed me that his previous dosage, while it helped, wasn’t helping enough! Sure enough, the higher dose is helping with schoolwork, but making sleep a bigger struggle.

I’ve looked up articles online but they all have the same suggestions. Parents of kids with ADHD kids—and folks with ADHD yourself—please tell me what has helped you?

Here’s what we already do:

-Adderall as early as possible (around 7:45am, right after breakfast)
-No screens within 4 hours of bedtime (limited screen time in general, distance learning stuff notwithstanding)
-Melatonin 1 hour before bed
-Relaxing bedtime routine of bath and reading
-Consistent bedtime
-Blackout curtains and white noise machine
-Exercise (usually)-though with the air quality unfortunately he’s not getting much exercise right now

I'm wondering if we need to tweak something we're already doing--like a higher dose of melatonin, or more exercise--if either of these have helped you, can you tell me how much exercise you need to get the positive effects, or how much melatonin you take?

Are there any calming exercises that helped you? Specific apps or resources you like?

Some articles mention deep touch pressure therapy or weighted blankets--wondering if those are worth investigating?

Did prescription sleep meds help? What type, and what were the side effects? I’m reluctant to go down this road but I don’t want to rule them out if all else fails.

Any other tips or suggestions are also welcome!

Thank you!

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RE: ADHD and sleep solutions? ()

No sugar - reduce or entirely cut the sugar. Kids need 20 mins of morning sunlight (wear protection if done between 9-12pm) morning sunlight is best - this is to kick circadian rhythm back into action. Aside from device use, sugar and insulin spikes is prohibitive when it comes to sleeping. Melatonin is actually not that helpful for achieving sleep (your body makes it naturally and you need to increase that melatonin production, not synthetic melatonin).

Keep in mind Adderall is a form of an amphetamine. Doctors (I'm married to one who focuses on sleep without promoting the use of pills), often fail to tell patients the ingredients in Adderall (well any medications, really). Sleeping pills help knock out but leave empty promises of "deep sleep" - that is - the level of sleep where our bodies and brains recover. 

It appears as though you're doing it right with what you described - of course timing is everything and you take that into consideration, from what you described.

Weighted blankets often help (although not for everyone). Keep the room temperature cool (body temperatures is extremely important when attempting to get real sleep). Use blankets for warmth. Our kids take cold showers before bed and have weighted blankets (one loves it, the other two are not fans). 

Darkness - yes - sleeping masks are helpful. 

I would swap out melatonin for magnesium lotion. Most of us are magnesium deficient. That's a big barrier when it comes to achieving sleep. 

Going to bed at the same time and getting up at the same time is extremely important. 

I have three kids and we were in many different time zones for a period of time; we kicked their circadian rhythms back in by doing art with music and yoga (our two year old at the timed just cried and watched but over time saw how calm the others were so he opted for reading books). Oh, reading books to my kids while they're tucked in is an instant sleeping pill! 

If you want to know what's really going on with sleep,  the Oura Ring can be super helpful. I use it to solve many of our sleeping, or lack thereof, mysteries. 

RE: ADHD and sleep solutions? ()

Hi there!

I’m a mom of kids with ADHD who also has ADHD. Adderall can be brutal on sleep- I struggle with this balance in my adult body.

A few thoughts- did your child have sleep struggles pre-medication?

Did the increase in dosage coincide with a decrease in outdoor exercise? My unmedicated guys sleep horribly without outdoor exercise (& when their Mama is stressed too). 

Does he have trouble falling asleep, staying asleep or both? (Melatonin only supports falling asleep)

Two supplements that might help are Magnesium & Vitamin C. Magnesium is calming and could become a part of your afternoon & evening routine. Vitamin C helps Adderall exit the body. 

Lastly, maybe discuss with your doctor IR vs XR. For me, sleep is an absolute priority- I’m scattered and cranky without it. After much tinkering, most days now I take just an IR dose in the morning and plan anything that requires attention in that window of effectiveness. As it wears off in the afternoon, I try to be outside, exercise, be creative and mellow out. IR has a half life of, I believe, 10-12 hours so I’m asking my body to deal with a lot less stimulant at bedtime than if I had taken a second dose (XR is basically the same as 2 IR doses 4 hours apart).

This is how I’ve been able to balance this unfortunate side effect. Most days. Unfortunately, I have ADHD 24 hours a day, every day, and some days life, work, etc necessitate more intervention. On those days, I take the second dose and know that I have to make a concerted effort to sleep. For me, that equals lavender oil, sleepytime tea, and yoga nidra meditation. Which works sometimes. 
Best of luck to you. And do some of that nighttime care-taking for yourself, mama. These aren’t the easiest of times. 

RE: ADHD and sleep solutions? ()

Hi!  We had a similar situation with our son.  It looks like you're doing an even better job than we did:-D  But one thing we tweaked that weirdly seemed to work pretty well was to give the melatonin in two stages--half a tablet an hour before bed and the other half 30 minutes before bed.  Not sure why, but that worked much better than giving it to him all at once.  Good luck!

RE: ADHD and sleep solutions? ()

My 11 year old son has high functioning autism and takes Vyvanse for attention issues.  Since he was little, even before vyvanse, he had difficulty getting to sleep.  It didn't get worse with medication but it has remained an issue. He describes it has his mind racing and not being able to settle down. We use most, if not all of the measures you have identified.  However, for the past few years he has also used a weighted blanket which has made a huge difference!  It just helps still his body and lets his mind rest. I got it through Target so it wasn't super expensive. It has been a life saver.  He usually moves out from under it in the middle of the night but it has done its job.  I'd highly suggest trying one. 

RE: ADHD and sleep solutions? ()

We have exactly the same issue and have not found any magic solution.  We've had to compromise on the optimal dosage and medication length--choosing a medium instead of long-acting stimulant at a slightly lower dose than necessary because of the dramatic affects on my son's sleep.   

We do give him the meds at 6:15am, right as he's starting to eat breakfast, which helps (probably not helpful if you're not up early--I've started getting up earlier to have his breakfast ready first thing).  Melatonin definitely helps and he takes 3 mg about an hour before bedtime.   We tried a weighted blanket and although he liked it, it did not help with the sleep issue. 

It's so hard because sleep and attention are both so important. You have my sympathy!  

RE: ADHD and sleep solutions? ()

As a Mom of 2 boys with ADHD I can tell you there are lots of ADHD drugs and finding the right drug for your kid that improves attention and decreases impulsity is an art, not necessarily a science with medication effects and side effects differing from kid to kid.   Some drugs like Adderal are long acting. There are others that are shorter acting.  Maybe one of these would be better for your son. I can tell you that one of my sons did poorly on Adderall and developed improved focus but a really flat affect which made peer relationships even harder.  Our psychiatrist switched him to Vyvanse, another long acting ADHD med and he was able to focus AND have his funny quirky personality shine through.   My younger son does better on a shorter acting ADHD med.  So before you add on a sleeping pill, I would go back to the prescribing psychiatrist, describe your son's symptoms on Adderall, and ask to try another ADHD med.   I support you in all the other non-pharmacologic things you are doing!

RE: ADHD and sleep solutions? ()

You have got a good plan. I would make sure that the white noise you are using is something your son thinks is relaxing. Some people like the sound of a fan, but that is not relaxing to others! There are so many choices, make sure he has the right one: rain? heartbeat? crashing waves? If you can possibly manage it, he should get exercise outdoors in green spaces. There is actually good research showing green spaces ameliorate ADHD. 

Next is fragrances. Many people do not realize that fragrances are causing them to feel bad. Laundry detergent, and fabric softeners are especially bad, because of the sheets close to his face. I recommend fragrance free everything, including soap, shampoo, dish detergent, etc. And make sure all perfumes and colognes are removed from the house. This may seem extreme, but it is worth it. Also, remove any toxic cleaning products, such as bleach and ammonia from the house. Clean with only fragrance free detergent, water, and baking soda if you need an abrasive. Maybe a little vinegar on occasion for disinfecting. And no air fresheners!

Carpet in the bedroom? The formaldehyde in the glues is toxic. Remove that. Get a rug that has no backing or glue instead. 

You may want to consider a magnesium supplement. It can help with sleep. 

No mint toothpaste. That is a wake up flavor. In fact, you may want to try bushing teeth just once a day, in the morning. 

This takes some discipline, but progressive muscle tension relaxation can be quite effective: 

https://www.therapistaid.com/worksheets/progressive-muscle-relaxation-script.pdf

Meditation is also good. Many guided meditations are available online. 

Hope you are able to enjoy plenty of restful sleep soon. 

RE: ADHD and sleep solutions? ()

We always had good success with the melatonin, and take it closer to bedtime, like 15 minutes before.  We had a couple of different things we listen to -- beta waves for sleep (just search for it on youtube) and guided meditations.  You have to try some to see if there's one your kiddo likes.  Also, what time is your kid going to bed?  Maybe bedtime is just too early, especially if he's sleeping till 7:30 or 45.